The Physician's Digital Twin: Risks and Dangers of Loss of Identity for the Patient and Society

Advances in artificial intelligence offer possibilities for using a treating physician’s digital twin as an additional means of medical communication and patient psychoeducation. Yet reproducing a physician’s appearance, voice, and elements of professional communication does not guarantee the preservation of professional identity in a digital environment. This conceptual paper examines the potential loss of identity of a physician’s digital twin, defined as a disruption of the correspondence between a recognizable digital image, the physician’s current clinical intentions, and the content of patient interactions. Three groups of possible causes are proposed: discontinuation or weakening of the link with the treating physician; technical failures; and transfer or alienation of control to third parties. Potential clinical consequences are discussed, including disruption of therapeutic trust, worsening psychiatric symptoms, and iatrogenic harm. Particular attention is paid to the limits of patients’ ability to recognize changes in the twin’s behavior. An original conceptual proposal, the Alexander-Tschausovsky-Reflex, describes a previously learned protective response: recognizing an unusual change, discontinuing the interaction, and contacting a responsible professional. Such a response cannot replace medical oversight or automatic technical safeguards. This paper is theoretical. The proposed classification and protective model require empirical investigation and clinical validation.